The Adverse Childhood Experiences Study

Adverse Childhood Experiences (ACEs) are now recognized as a significant public health issue not only at the individual level but also globally. ACEs are defined as a range of experiences, including emotional, physical, and sexual abuse; emotional and physical neglect; domestic violence within the family environment; substance use within the household; mental health issues within the household; parental loss or separation; and a family member’s experience with crime or incarceration. One of the most comprehensive studies in this field has shown that these experiences often occur not in isolation but in combination, and that each adverse experience endured during childhood is directly linked to physical illnesses, mental health issues, and risky behaviors in adulthood.

The research clearly demonstrates that as the number of Adverse Childhood Experiences (ACEs) increases, so do the health, behavioral, and social adjustment risks an individual will face in later life. However, this process is not inevitable. Supportive relationships, secure attachment, and protective environments enable children to develop resilience, thereby transforming these negative effects.

Therefore, understanding adverse childhood experiences is not merely about identifying risks but also about establishing protective and preventive systems that strengthen children’s well-being.

POSSIBLE EFFECTS OF ADVERSE CHILDHOOD EXPERIENCES
Effects on Physical Health:

  • Heart disease
  • Diabetes
  • Obesity
  • Immune system problems

Effects on Mental Health:

  • Depression
  • Anxiety
  • Post-traumatic stress disorder (PTSD)
  • Substance use and addiction

Behavioral Effects:

  • Prone to risky behaviors
  • Failure in education
  • Instability in work life

Prevention and Intervention of Adverse Childhood Experiences:

  • Awareness Building: Organizing educational programs for families, schools, and the community.
  • Support Systems: Providing counseling, therapy, and social support services for children and families.
  • Positive Parenting Techniques: Providing children with a safe, supportive, and consistent environment.
  • Early Intervention: Identifying children at risk and providing them with the necessary support.

 
Prevalence in Turkey
Studies conducted in Turkey similarly reveal that a significant proportion of children are exposed to adverse experiences at some point in their lives.
A study conducted by Ege University in Izmir, Denizli, and Zonguldak found that more than 70% of children aged 11–16 reported experiencing at least one adverse childhood experience in their lifetime (Sofuoğlu et al., 2014). Psychological abuse, physical punishment, and neglect are the most commonly reported experiences.
Neglect is more prevalent among children living in rural areas, while psychological abuse is more common among those living in cities. Furthermore, the rate of exposure to negative experiences increases with age.
 
Protective Factors 

  • Not every child is affected by negative experiences to the same degree. Protective factors can reduce risks:
  • Secure attachment relationships (e.g., a supportive parent or teacher)
  • Positive support in school and social environments
  • Early psychological help and counseling services

In Turkey, the Turkish adaptation of the Childhood Adverse Experiences Scale (CAES) has been developed and its validity tested (Gündüz et al., 2018). Wider use of this scale could help identify at-risk children at an early stage. At the policy level, combating domestic violence, parenting education, strengthening child protection systems, and trauma-sensitive school programs are recommended.

Sources:
Felitti VJ, et al. (1998). The ACE Study. Am J Prev Med.
Sofuoğlu Z, et al. (2014). Türkiye’nin üç ilinde OCY epidemiyolojik çalışması. Ege Üniversitesi Yayınları.
Gündüz, Yaşar, Gündoğmuş, Savran, Konuk (2018). Çocukluk Çağı Olumsuz Yaşantılar Ölçeği Türkçe uyarlama çalışması.
Özşahin Ş, Aksakal N, Erdem A, Koldaş H, Santur A. (2022). OCY’nin gebelikte yakınmalar ve yaşam kalitesine etkisi. İnönü Üniversitesi Tıp Fakültesi.
Türkmen S. (2023). Çocukluk çağı olumsuz yaşantılarının cinsel yaşam kalitesine etkisi. İnönü Üniversitesi.
Barut, Baransel, Uçar, Çelik (2023). Etnik yapılar arasında travma düzeylerinin karşılaştırılması. Sosyal ve Siyasal Araştırmalar Dergisi.
Türkiye Klinikleri (2021). “Olumsuz çocukluk çağı deneyimleri ve gelişimsel riskler.”